The nurse is caring for a client newly diagnosed with hypertension. Which statement by the client indicates the need for further teaching?

A. Pleurisy:

Pleurisy is inflammation of the pleura, which is the lining surrounding the lungs. It can cause sharp chest pain that worsens with breathing. While pleurisy can be associated with conditions such as infections, pneumonia, or pulmonary embolism, it is not typically directly diagnosed or investigated using the brain (B-type) natriuretic peptide (BNP) test. The symptoms of pleurisy may include chest pain, especially with deep breathing, coughing, or sneezing.

B. Cardiomyopathy:

Cardiomyopathy refers to diseases of the heart muscle, which can lead to impaired heart function. Cardiomyopathy can cause symptoms such as fatigue, shortness of breath, chest pain, and fluid retention. While elevated BNP levels can be observed in some cases of cardiomyopathy, the BNP test is not specific to cardiomyopathy alone. It is often used to assess and diagnose heart failure, a condition that can result from various cardiac abnormalities, including cardiomyopathy.

C. Valve Dysfunction:

Valve dysfunction refers to abnormalities or malfunctions of the heart valves, such as stenosis (narrowing) or regurgitation (leakage). Valve dysfunction can lead to symptoms such as shortness of breath, chest pain, palpitations, and fatigue. While valve dysfunction can contribute to heart failure by causing pressure and volume overload on the heart chambers, the BNP test is primarily used to assess heart failure itself rather than specifically identifying valve dysfunction.

D. Heart Failure:

Heart failure is a condition in which the heart is unable to pump blood effectively to meet the body's needs. It can cause symptoms such as fatigue, shortness of breath, fluid retention (edema), and exercise intolerance. Elevated BNP levels are commonly observed in patients with heart failure, especially in cases of acute exacerbations or decompensated heart failure. The BNP test is used to assess and diagnose heart failure, as higher BNP levels indicate increased cardiac stress and volume overload.

A. When the client states he is ready to start the infusion:

While it's important to consider the client's readiness and cooperation, the timing of the infusion should not solely depend on the client's statement. The priority is to start the infusion promptly after receiving the packed red blood cells (PRBCs) from the blood bank to ensure their safety and effectiveness.

B. As soon as the nurse can prepare the client and the administration set:

This choice is the correct answer. After receiving the unit of PRBCs from the blood bank at 1130, the nurse should begin the infusion as soon as possible after preparing the client (ensuring the correct patient, verifying the blood type compatibility, obtaining informed consent, etc.) and the administration set (priming the IV tubing, checking for any leaks, etc.). Prompt administration helps prevent delays that could compromise the quality of the blood product.

C. 2 hours after obtaining blood from the blood bank:

Waiting for 2 hours before starting the infusion is too long and could exceed the recommended timeframe for administering PRBCs after obtaining them from the blood bank. Delaying the infusion for such an extended period could impact the viability and safety of the blood product.

D. When the client has finished eating lunch:

The timing of the client's meal is not a factor in determining when to start the infusion of PRBCs. While it's generally important for the client to have adequate nutrition and hydration, the priority is to administer the blood product promptly after preparation to ensure its efficacy and safety, rather than waiting for unrelated factors such as meal times.